CW: Neglect
The story of Damon Brooks, a paraplegic living in Washington, D.C., and a sports journalist, is a harsh reminder of the fragility of home care when oversight fails. According to NBC Washington, Brooks has footage of his overnight staff sleeping while on the job. These home healthcare workers are supposed to take care of Brooks and be available in case of an emergency. What he finds instead is the staff asleep in chairs, on couches, and even bundled up on the floor.
Brooks is dependent on these home healthcare workers for support with his activities of daily living. However, the video clips he has posted paint a different picture—and one that suggests a pattern among advocates. Brooks says that he has been left sitting on wet underpads, and has missed catheterizations.
These workers are being paid by a Medicaid-funded program. The very program that is supposed to help people is hurting them.
However, another contributing factor to this problem according to advocates, is the larger crisis within the direct care workforce itself. Due to low pay, high turnover, and chronic understaffing, the workforce is one in which agencies and individuals struggle to find and retain direct care staff.
Home health aides and personal care aides are paid much lower than other entry-level employees in Washington, D.C., and had a median national hourly wage of only $15.18 in 2023, nearly $4 per hour lower than other entry-level workers, when factoring in cost-of-living adjustments for entry-level workers. Reports have emerged that D.C. has lost one‑third of its direct care workers in recent years, largely because of the lack of decent pay, adequate training, and career advancement opportunities, sources say.
Brooks’ story is all too familiar within a system stretched to its limits. When employees are underpaid and unsupported, the quality of care inevitably suffers, leaving people vulnerable in their own homes.
I have experienced similar frustrations because I have cerebral palsy. In my first three semesters of college, before the pandemic, I had three PCAs. It was already a stressful time in my life, and it was an added stress when I had to wonder if I would be able to get to class on time and if I would be able to go to the bathroom. It should not be a luxury to be able to count on someone, but it often is.
Advocates stress that this is not just a matter of individual negligence but is the natural consequence of a workforce crisis, one where agencies struggle to hire, employees burn out quickly, and those who remain often juggle several jobs just to make ends meet.
Without meaningful investment in the direct care workforce, these problems will only worsen. Higher wages, better training, and career pathways are seen as essential steps to stabilizing the field and ensuring that people like Brooks receive the reliable, dignified care they deserve. His story is a stark reminder that when the system fails its employees, it ultimately fails the people who depend on them most.
Sources:
Wilkins, Tracee, et al. “Paraplegic DC Man Says His Nurses and Aides Sleep on the Job as Advocates Flag Risks.” NBC Washington, NBCUniversal Media, 18 Dec. 2025, https://www.nbcwashington.com/investigations/paraplegic-dc-man-says-his-nurses-and-aides-sleep-on-the-job-as-advocates-flag-risks/4031418/..
Wages of Direct Care Workers Continue to Be Lower in Most States Relative to Other Entry-Level Jobs. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, 20 Dec. 2024, https://aspe.hhs.gov/sites/default/files/documents/9f37d617a1b21bf0c2dfad433b1c95af/dcw-entry-level-wages-continue-lower.pdf..